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Health Insurance in the Netherlands



When living in Netherlands, it is mandatory to have a health insurance contracted with a Dutch insurer. The expat insurance from your country of origin is not valid. Not having a valid health insurance is not accepted and you will be warned and fined. Get a Dutch health insurance as soon as possible.

If you don’t get a Dutch health insurance, the process is the following:

  • You receive a letter from the Dutch government. They warn you that you should have an insurance or you will be fined 400€.
  • If in 1 month you did not obey, you get another warning and the fine.
  • Again it repeats: warning and fine if you still did not obey.
  • And finally, you get another fine and forceful registration in a basic Dutch health insurance.

Considering that insurance payment is (often) retroactive, I suggest you to insure yourself as soon as you register in Netherlands. Don’t think that they will not catch you, Netherlands is very well organized. It is very unlikely that you will be unnoticed.

The basic Dutch health insurance coverage

The health insurance covers basic health items, mostly General Practitioner (house doctor). It also covers (some) specialist checkup when you are sent by the GP. However, it does not completely cover analysis costs such as blood exam or X-ray. These costs fill in the ‘expenses’ bucket (own-risk).

The expenses bucket has a limit that you should pay yourself, called ‘eigen risico’ (own risk). That limit for 2019 has a minimum of 385€. That means that you should pay up to 385€ for the derivated costs of your health condition. It is possible to increase the own risk in order to lower the insurance cost. Typical rate is ~36€/year per each 100€ of own risk increase. For instance, it would be possible to increase the own risk to 885€ and get a 180€/year discount.

Restitution mode: Naturapolis vs Restitutiepolis

The basic health insurance coverage by law is the same for all companies. However, there are still differences in number of hospitals covered and procedure to pay the costs. The cost of a basic health insurance is around 100€ regardless of the provider. The main price difference we can find is the kind of policy: naturapolis or restitutiepolis.

  • With naturapolis, the insurance company pays directly the treatment to the contracted health institution. We can also visit non-contracted health providers, but there is a limitation in the rates (capped).
  • With restitutiepolis there are no contracted health institutions. Health insurance refunds the expenses according to some tables, so we have to be careful which providers we use, as they may be above of those tables.

In both cases, standard treatment values are stipulated in tables. In the case of naturapolis, as long as it is a contracted provider they have an agreement with the insurer, hence their tables are not relevant anymore.

General Practitioner doctor

In Netherlands the health system is a bit weird at the beginning. You have to register in your GP (home doctor) before you can go, and often you get assigned the closest doctor to your home. Something similar happens with the pharmacy: your GP will request your medicines to a given pharmacy. Forget about picking them up in any pharmacy, you have to go to your assigned pharmacy.

On the other hand, that implies that there is no difference in your health insurance regarding your GP: you will go exactly the same doctor, regardless of your insurance. Things get a bit different with bigger issues like specialists, and definitely with additional packages, but that is for the next section.

Extra coverage by additional packages

Dutch are quite insurance-prone, and you have a myriad of different extra packages to choose from. For instance, you can chose to add alternative medicine, physiotherapy or dental care. Of course, the higher the premium you pay the higher the coverage. But chose wisely, as these options do not add any value if you do not use them.

The main difference with the basic insurance, is that to use these packages you do not have to go through the GP and the costs are not going to the own risk.

For dental, there are several different options available, also depending on the provider. Some providers insure up to 500€ but only 70% of the value, while others may insure up to 100% of the cost but only up to 350€. Beware that dental insurances may cover 100% of some treatments (filling) while only 75% of others (implant). To avoid surprises check in detail your insurance characteristics, and use an insurance comparator such as independer when getting your insurance, you can even get a very nice deal through them

Beware that still some costs may be in the tables, and if you go to a given specialist the cost may not be fully refunded, regardless if you have coverage.

Special insurance for expats

There is an interesting insurance option which is only available for expats. The main advantage as expats is that it is quite likely that a treatment in our country of origin is cheaper than in the Netherlands, as it is one of the top 6 in expenditure. Therefore, we can afford to get the basic insurance, without added packages. Still, whenever we go to doctor we still have to pay the own-risk for any treatment. To cover these cases, HollandZorg has an interesting combo insurance called ‘no own-risk’. That insurance is a combination of a basic health insurance and an ‘own risk’ insurance.

The health insurance has the ‘own-risk’ franchise set to maximum (885€). But the own-risk insurance covers up to 385€ of own-risk. Update for 2020, there is no own risk. The extra insurance covers the own-risk from 0 to 885€. The basic health insurance covers any normal medical procedure. Beware however, that it does not cover any extra items like vaccines, dental, nor physio.

If you don’t want a special package, this insurance is one of the best available: for 107€ premium you have own-risk cover.

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